Berger, Tim; Chikvatia, Salome; Siepe, Matthias; Kondov, Stoyan; Meissl, Dominic; Gottardi, Roman; Rylski, Bartosz; Czerny, Martin; Kreibich, Maximilian (2023). Concomitant aortic root replacement during frozen elephant trunk implantation does not increase perioperative risk. European journal of cardio-thoracic surgery, 63(4) Oxford University Press 10.1093/ejcts/ezad053
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OBJECTIVES
Our aim was to evaluate the risk of concomitant aortic root replacement during frozen elephant trunk (FET) total arch replacement.
METHODS
Between 03/2013 and 02/2021, 303 patients underwent aortic arch replacement using the FET technique. Patient characteristics, intra- and postoperative data were compared between patients with (n = 50) and without (n = 253) concomitant aortic root replacement (implantation of a valved conduit or using the reimplantation valve sparing technique) after propensity score matching.
RESULTS
After propensity score matching there were no statistically significant differences in preoperative characteristics including the underlying pathology. There was no statistically significant difference regarding arterial inflow-cannulation or concomitant cardiac procedures, while cardiopulmonary bypass (p < 0.001) and aortic cross-clamp (p < 0.001) times were significantly longer in the root replacement group. Postoperative outcome was similar between the groups and there were no proximal reoperations in the root replacement group during follow-up. Root replacement was not predictive for mortality (p = 0.133, odds ratio: 0.291) in our Cox regression model. There was no statistically significant difference in overall survival (log rank: p = 0.062).
CONCLUSIONS
Concomitant FET implantation and aortic root replacement prolongs operative times, but does not influence postoperative outcomes or increase operative risk in an experienced high-volume centre. The FET procedure did not appear to be a contraindication for concomitant aortic root replacement even in patients with borderline indications for aortic root replacement.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery |
UniBE Contributor: |
Siepe, Matthias |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1873-734X |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
23 Feb 2023 11:55 |
Last Modified: |
27 Feb 2024 14:27 |
Publisher DOI: |
10.1093/ejcts/ezad053 |
PubMed ID: |
36808408 |
Uncontrolled Keywords: |
aortic arch aortic root aortic root replacement frozen elephant trunk (FET) |
BORIS DOI: |
10.48350/179050 |
URI: |
https://boris.unibe.ch/id/eprint/179050 |
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